Under the Affordable Care Act, dental care for children under age 19 is covered by all insurance plans as an “essential health benefit”. However, the law does not currently require health insurance plans to offer mandatory dental coverage to adults. For that reason, you will need to purchase a separate dental insurance plan if you want to obtain these types of benefits. Some people also enroll their children in these optional family dental plans due to greater availability of providers or lower out-of-pocket expenses.
The same goes for vision insurance. Children receive vision care as an essential health benefit under all Covered California health insurance plans, but there is no such provision for adults. As with dental care, you have two options: Pay for all vision services out of pocket, or purchase a vision insurance plan.
Yes, the “bad news” is that you must purchase separate dental and the importance of having an insurance policy!
If you choose to shop for dental and vision insurance, remember to compare these important points across all plans that you consider:
- Premiums versus other out-of-pocket expenses – as with all types of insurance, a lower deductible will probably mean a higher premium. Run the numbers to determine which level of coverage will save you the most money.
- Availability of providers – this can be very important if you have a favorite dentist or optometrist. Make sure your provider accepts the insurance plan that you choose. If you don’t have a favorite provider, check to see how many covered providers are available in your area.
- Coverage limits – dental and vision insurance plans can be confusing, so examine the fine print carefully. Some procedures might not be covered, or they are only covered after a specific waiting period.
For more information on choosing a dental or vision insurance plan, give us a call. We can help you compare your options and budget. Remember, these insurance plans are not subject to the annual Open Enrollment period – so you can purchase coverage today!